Individual provider Active NPI

Janeal N Johnson, LPN

  • Licensed Practical Nurse
  • Marietta, GA
National Provider Identifier
1306467923
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN095509 Issued in GA
Practice address
1758 County Services Pkwy SW
Marietta, GA 30008-4012
Phone
(404) 794-4857
NPI assigned
May 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN095509 GA Primary

Addresses

Primary practice location

1758 County Services Pkwy SW
Marietta, GA 30008-4012

Mailing address

5751 Riverdale Rd Apt 36H
Atlanta, GA 30349-6389
Phone (678) 392-7565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN095509GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers CSB PastSince May 10, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1306467923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 RIVERDALE RD APT 36H",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303496389",
            "telephone_number": "678-392-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1758 COUNTY SERVICES PKWY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300084012",
            "telephone_number": "404-794-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JANEAL",
        "middle_name": "N",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN095509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.